A 10-Year Retrospective Review Of Anterior Capsular Tears In Phacoemulsification Cataract Surgery, Its Associations And Rates Of Posterior Capsular Rupture.

To determine rates of anterior capsular tear (ACT), rate of ACT progression to posterior capsular rupture (PCR), frequency of PCR, frequency of vision blue use (VB) and factors that contribute to ACT during phacoemulsification cataract extraction (PCE).

A large, multicentre NHS teaching hospital trust in London. Surgeon’s experience ranged from first year specialist trainee doctor (ST1) through to consultant.

Retrospective review of 10 years of complete electronic PCE operation records from January 2011 to January 2021. The variables extracted from the records were surgeons’ grade, gender, VB use, occurrence of ACT and PCR .

During the 10-year period, 140932 eyes underwent PCE. There were 1854 ACT (1.32%), of which 246 (13.3%) proceeded on to a PCR. The number of PCRs over the 10 years was 2231 (1.58%). Protective factors against ACR were consultant surgeon (OR  0.7, p= <0.0001) and female gender (OR 0.8, p= <0.0001). VB was used in 1541 cases (1.09%), in these cases there was a higher rate of ACR than those without VB (OR 5.3, p= <0.0001).

Consultant surgeons and female gender were found to reduce the risk of ACR. VB was associated with increased ACR, which could suggest it is independent risk factor for ACR or could be related to a selection bias. Absolute numbers for ACR and PCR allow for more accurate data to provide patients with when obtaining informed consent for PCE.